Where did science settle around the foreskin?


From trepanation, the process of drilling a hole in the skull to release evil spirits, to cataract surgery, a number of ancient medical practices are still executed today. Among the most common and contested persistent procedures: circumcision.

Although the procedure has evolved over time and can vary greatly from culture to culture, the basic steps have remained the same: a medical professional or spiritual healer uses a sharp object to remove the piece of skin which covers the tip of the penis.

Circumcision rarely takes more than ten minutes to perform, but its consequences remain with recipients until the end of their lives. A circumcision can influence how people perform basic bodily functions like urinating, and often plays an important role in their privacy as well.

Amid its current widespread practice, circumcision raises a number of unresolved questions. As with many centuries-old surgeries, experts don’t entirely agree where its religious significance ends and its medical benefits begin. Some medical professionals have argued that the foreskin — while often seen as unnecessary and impractical — may actually serve a crucial, hidden purpose.

The origins and benefits of circumcision

How circumcision began remains a mystery. In Abrahamic religions, the practice can be trace back to Abraham’s covenant with God. But circumcision is actually much older than the religions that codified it: ancient reliefs indicate that circumcision was the first systematically practiced in Sixth Dynasty Egypt, possibly during an induction ritual for new priests.

Some experts believe that the increasing prevalence of circumcision in cultures around the world has occurred because of its health benefits. For example, nomadic communities with infrequent access to water may have adopted this practice for hygiene purposes. By promoting fertility, circumcision could have enabled communities to grow and therefore expand their practice.

But most of the origin stories behind circumcision concern religious issues rather than reproductive health. The first doctor to promote circumcision, Jonathan Hutchinson, led a flawed but nonetheless influential study in 1855. His work hypothesized that the circumcised Jewish population of London was less vulnerable to venereal disease than their uncircumcised neighbors.

The Foreskin, Hutchinson Explain in 1890, “provides a haven for filth and is a constant source of irritation. It leads to mastery and adds to the difficulties of sexual continence. This increases the risk of syphilis in early life and cancer in older people.

Hutchinson was not the only doctor to promote circumcision to non-religious patients. Other notable medical professionals, including pediatrician Nathaniel Heckford and New York surgeon Lewis Sayre, claims circumcision could be used as a viable treatment for a number of ailments, from paralysis to chorea and epilepsy.

The idea that circumcision was medically beneficial spread from England to the United States and across the world. The South Koreans, for example, began circumcising young people after the Korean War. Influenced by American involvement, they cited health reasons as the primary motivation behind their state-sponsored circumcision programs.

Foreskin: The Vital vs. Vestigial Debate

It should be noted that Hutchinson, Sayre, and Heckford worked in the Victorian era, a time when exceptionally prudish societal norms caused parents, doctors, and government administrators to view the procedure as a viable means of preventing their children from masturbate.

John Harvey Kellogg, an American doctor and nutritionist known for his brand of cornflakes, was a firm believer in circumcision for this very reason. In his 1888 book, Clear facts for young and old, he wrote that the procedure is “almost always successful in small boys”, adding that “the operation must be performed by a surgeon without administering anesthetic”.

Kellogg believed that the “brief pain associated with the operation” would have a “salvific effect on the mind, especially if linked to the idea of ​​punishment”. After the Victorian era ended and attitudes towards sex changed again, sentiments like these inspired modern doctors to take a closer and more specific look at circumcision.

In 1946, physician Douglas Gairdner published an influential newspaper who considered the supposed health benefits of the procedure with a new perspective. Although circumcision can indeed be used to treat conditions such as phimosis (the difficulty or inability to retract the head of the penis), these conditions are too rare to warrant widespread implementation of the technique.

In the same article, Gairdner proposes that the foreskin is far from vestigial, a term applied to features that have lost their function during evolution. Instead, he says, it may actually serve a small but important purpose in newborns: to protect their sensitive glans from any irritation or injury that may result from contact with soggy clothes and diapers.

Capitalizing on the rapidly changing zeitgeist in the medical world, Gairdner’s research garnered widespread support and spawned groups of activists like doctors opposed to circumcision. Such organizations argue that since almost every type of mammal on the planet has been given a foreskin, there must be some logical explanation for its existence.

Circumcision and Penile Sensitivity

Although Gairdner’s study has become influential, it was published at a time when medical research on reproductive organs and sexually transmitted diseases was thin. The last few decades have seen a drastic increase in studies, most of which have come at odds with the original investigation.

A 2005 Archives of childhood illnesses neonatal circumcision study found that the procedure can reduce urinary tract infections in infants by up to 90%. Other studies have highlighted how this reduced risk could continue into adulthood. Overall, the accumulating evidence on the health benefits of circumcision has prompted American physicians to wonder why their European colleagues do not promote surgery.

Although anti-circumcision activists may claim that the foreskin protects against STDs, studies have shown the opposite when it comes to diseases such as HIV. In fact, aggregated data from clinical trials in Africa indicate that uncircumcised men may be twice as likely to contract HIV like circumcised.

The final, and perhaps most interesting, factor in the circumcision debate: whether having a foreskin enhances male pleasure during sex. George Denniston, the founder of Doctors Against Circumcision, claims that the “stiff band” at the end of the foreskin is filled with nerve endings that are stimulated by intercourse and masturbation.

A 2013 study conducted by the British Journal of International Urology also alluded to “the importance of the foreskin to penile sensitivity” after a large population of circumcised men reported a decreased sexual pleasure. The study was heavily criticized and sparked further investigations which concluded that circumcision neither decreases nor increases pleasure.

Thus the question of penile sensitivity, like many other uncertainties around circumcision, remains unanswered. The researchers hope that the growing raw data could eventually paint a clearer picture.

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